Objective To assess the characteristics and satisfaction of outpatients in walk-in clinic of a grade A tertiary hospital.Methods A total of 1 100 outpatients visiting walk-in clinic of the Second Hospital of Hebei Medical University during March 2016 and June 2016 were randomly selected for the questionnaire survey.The self-designed questionnaire included the general information of patients,the satisfaction degree to the walk-in clinic,to special clinics of the hospital or to community clinics and related reasons,and suggestions for further improvement.Results Total 947 valid questionnaires were received with a retrieval rate of 86.09％.Most of participants had one chronic disease (594,62.72％).The satisfaction degree of walk-in clinic (1.78) was higher than that of hospital special clinics (1.93) (P =0.010),in turn the latter(2.33)was higher than that of conmmnity clinics (P ＜ 0.001).The reasons for patient to choose the walk-in clinic were wide range of medications (389,41.08％),reliable quality (285,27.98％),short waiting time (249,26.29％) and so on.Suggestions for improvement of the walk-in clinic were further reducing the waiting time (428,45.20％),need specialists for chronic disease management (210,22.18％),raising reimbursement rate (172,18.16％) and so on.The reasons for patients to choose special clinic were need readjusting prescription (587,61.99％),special disease or drug (427,45.09％).The reasons of dissatisfaction with special clinic were long waiting time (476,50.26％),frequent transfer to multiple departments (221,23.34％),high registration fee (221,23.34％).The reasons for patients to choose community clinic were short distance (350,36.96％),better environment (350,36.96％),short waiting time (184,19.43％).The reason of dissatisfaction with community clinic were low qualification of medical staff (405,42.77％),insufficient medications (392,42.39％);distrusting the quality of drugs (263,27.77％).Suggestions for improvement of the community clinics were upgrading the qualification of medical staff (317,33.47％),enlarging drug variety (298,31.47％),improving medical environment (94,9.93％) and so on.Conclusion Most outpatients visiting walk-in clinic of grade A tertiary hospital are highly satisfied the clinic.To meet the patients' needs the primary medical unit should further improve their overall service.

Objective:To investigate the effect of applying narrative therapy theory into game on improving the quality of bowel preparation in children, and to provide a basis for selecting nursing intervention methods before bowel preparation.Methods:This study was a quasi experimental study. Totally 62 children who took polyethylene glycol electrolyte dispersion for bowel preparation in Gansu Maternal and Child Health Hospital from January to December 2021 were included in this retrospective study. They were divided into control group with 28 cases and experimental group with 34 cases according to random number table method. The control group was given conventional bowel preparation and medication guidance, and the experimental group was given the intervention during bowel preparation by applying narrative therapy theory implanted games. The bowel preparation adequacy rate, complete medication taking rate and parental satisfaction of the two groups were observed and compared.Results:The bowel preparation adequacy rate and complete medication taking rate in the experimental group were 94.12% (32/34) and 52.94% (18/34), respectively, which were higher than 46.43% (13/28) and 10.71% (3/28) in the control group, and the differences were statistically significant ( χ2 = 15.23, 10.41, both P<0.01). According to the average BBPS score, the experimental group had better intestinal cleanliness compared to the control group (7.65 ± 1.07 vs 6.07 ± 1.41, t = -4.87, P<0.01), the difference was statistically significant. 97.06% (33/34) of the parents in the experimental group expressed satisfaction, which was higher than 64.29% (18/28) in the control group, and the difference was statistically significant ( χ2 = 12.74, P<0.05). Conclusions:By applying the narrative therapy theory implanted games, the complete taking of high-dose bowel cleasing agent can be promoted and the quality of bowel preparation can be improved, which is worth suggesting as a nursing intervention method for bowel preparation.

Objective To survey on training for general practice backbone mentors in tertiary hospitals of Hebei province.Methods A questionnaire survey on training status was conducted among general practice backbone mentors in tertiary hospitals of Hebei Province.The survey items included the basic information,knowledge of general practice and its training,suggestions for mentors training and general practice discipline construction in tertiary hospitals.Results Total 208 questionnaires were distributed and 208 were retrieved with a recovery rate of 100％.Among 208 participants,all of them were over the age of 30;202 (97.1％) had bachelor degree or above;202 (97.1％) were attending doctors or above;165 (79.3％) had worked for more than 10 years;169 (81.3％) had no or little knowledge of general practice;159 (76.4％)had not received general practice training before;124 (59.6％) thought that general practitioners were not qualified as "gatekeeper" at present;and 192 (92.3％) worked in the hospitals providing standardized residency training.The training contents in general section were prioritized as clinical skills,community health service development and policy,rules for general practice standardized training,theoretical training,the present situation and countermeasure of general teaching,the doctor-patient relationship and medical ethics.The contents in training method section were prioritized as lecture series of clinical medicine,case discussion,seminar,distance education with classroom teaching.The suggestions for mentors training included:the exploration of standardized training model,perfecting continuing education system for general practice mentors,more attention to the training at community health service centers and the consummation of general practice system.The suggestions for general practice discipline construction were that more attentions should be paid by the government and the hospitals leaders,the general practice departments in tertiary hospitals should closely cooperate with community health service centers in training ofqualified general practitioners.Conclusions The specialists in tertiary hospitals of Hebei province do not have enough knowledge about general practice and do not quite understand the necessity of establishment of general practice department,so the training for general practice mentors should be strengthened and improved.Properly policy and more social resources from the government and the hospitals leaders will be helpful for construction of general practice discipline in general hospital.

Objective To investigate the influence of WeChat + family centered health intervention on the self-efficacy of elderly hypertensive patients in General clinic. Methods A total of 102 elderly hypertensive patients aged≥60 years in General clinic from February 2017 to July 2017 were enrolled.They were divided into experimental group and control group with the table of random number, with 51 cases in each group. The experimental group used the WeChat+ family centered health intervention model,while the control group adopted the traditional health education model.The changes of blood pressure and self-efficacy were evaluated before intervention, 3 months and 6 months after intervention respectively. Results There were no statistic significant difference in blood pressure and self-efficacy total score between the two groups before intervention(P>0.05). At 3 months after intervention,the blood pressure(systolic pressure/diastolic pressure)of the patients were(144.20±4.60), (80.00±5.00)mmHg(1 mmHg=0.133 kPa)in the experimental group,those of which were(154.20±7.16), (87.00±3.81)mmHg in the control group,the differences were statistically significant (t=-2.628,-2.490,P<0.05).At 6 months after intervention,the blood pressure(systolic pressure/diastolic pressure)of the patients were(141.60±6.43),(76.00±4.85)mmHg in the experimental group,those of which were(151.60± 5.94),(85.40±4.56)mmHg in the control group,the differences were statistically significant (t=-2.555,-3.158,P<0.05).There were differences in systolic and diastolic pressure in patients with different groups at different time,and the differences were statistically significant(F=18.668,18.174,P<0.01).The total score of self-efficacy at 3 months and 6 months after intervention was(30.14±0.43),(32.56±0.23)points in the experimental group and (28.14 ± 0.15), (29.40 ± 0.19) points in the control group, the difference was statistically significant(t=9.736, 23.819, P<0.05). The differences in the total score of patients′self-efficacy in different groups at different time had statistically significance (F=2 631.551, P<0.01). Conclusions The WeChat+family centered health intervention model can significantly improve the self-efficacy of the elderly patients with high blood pressure in the General clinic.